psychological Define disorder
-Psychological dysfunction associated with distress
-impairment in functioning that is not a typical or culturally expected response.
Define atypical or not culturally expected?
Behavioral, emotional, or cognitive dysfunctions that are unexpected in their cultural context and
associated with personal distress or substantial impairment in functioning.
What is the science of psychopathology?
The scientific study of psychological disorders.
In what ways does a mental health professional function as a scientist-practitioner?
-Consumer of Science:Enhancing the practice
Evaluator of Science: Determining the effectiveness of the practice
Creator of Science:Conducting research that leads to new procedures useful in practice
Presenting Problem:
complaint reported by the client to the therapist. The actual treated problem may sometimes be a
modification derived from the presenting problem
Prevalence:
Number of people displaying a disorder in the total population at any given time
Incidence:
new cases of a disorder in a specific time period
Course:
Pattern of development and change of a disorder over time
Prognosis:
Predicted future development of a disorder over time.
What is the difference between chronic and episodic courses? What disorders might fit into each?
Chronic Course:
Tend to last a long time, sometimes a lifetime
Ex: Schizophrenia, alcoholism
What is the difference between chronic and episodic courses? What disorders might fit into each?
Episodic Course:
Pattern of a disorder alternating between recovery and recurrence
Ex: Mood Dissorders, Depression
Read and be acquainted with the case study of Charles VI: The Mad King (page 9)
FREEBIE: In keeping with the accepted method of treatment, moved to the country side in order
to
Restore the balance of humors C
Who was John Grey (briefly)?
Champion of the biological tradition in the US
Most influential psychiatrist at the time
Believed insanity was always due to physical causes, therefore the mentally ill should be treated
as physically ill.
Rest, diet, and proper room temperature and ventilation
When were the first effective medications for severe psychotic disorders created?
1927-insulin shock therapy
During the 1950s
What is moral therapy?
19th-century psychosocial approach to treatment that involved treating patients as normally as
possible in normal environments.
People 1st, abnormal behavior 2nd
What is the mental hygiene movement and with whom is it most often associated?
Mid-19th-century effort to improve care of the mentally disordered by informing the public of
their mistreatment headed by Dorethea Dix.
Id:
The animal within us.
The energy or drive of the id is the libido.in contrast to the thantos
Operates on the pleasure principle
Operates under the Primary Process, which is a type of thinking that is emotional, irrational, illogical, filled with fantisies, preoccupied with sex, aggression, selfishness, and envy
Ego:
The mediator between our Id and Superego. Ensures that we act realistically
Operates on the Reality Principle
Secondary process: logical and rational
Superego:
Conscience
Operates under the Moral Principles
Instilled by parents and culture
What are defense mechanisms?
Common patterns of behavior, often adaptive coping styles when they occur in moderation, observed in response to particular situations. In psychoanalysis, these are thought to be unconscious
processes originating in the ego.
Denial:
Refuses to acknowledge some aspect of objective reality or subjective experience that is apparent
to others
Displacement:
Defense mechanism in which a person directs a problem impulse toward a safe substitute.
Projection:
Falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object
Rationalization:
Conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or
self serving but incorrect explanations
Reaction Formation:
Substitutes behavior, thoughts, or feelings that are direct opposite of unacceptable ones
Repression:
Blocks disturbing wishes, thoughts, or experiences from conscience awareness
Sublimation:
Directs potentially maladaptive feelings or impulses into socially acceptable behavior
Who was Carl Rogers and what concepts were tied to his humanistic theories?
(1902-1987)
Originated client-centered therapy (person-centered therapy)
Therapist takes a passive role making as few interpretations as possible
Unconditional Positive Regard
Complete and almost unqualified regard and acceptance of a clients feelings and actions
Empathy
Sympathetic understanding of an individuals particular views
Who is considered the founder of behaviorism?
John B. Watson
Joseph Wolpe (1915-1997)
Pioneering psychiatrist from South Africa
Founder of systematic desensitization to help his clients with phobias
Used Behavioral Therapy
B.F. Skinner (1904-1990)
Operant Conditioning: behavior changes as a result of what happens after the behavior
Reinforcement, shaping
What is the multidimensional integrative approach to psychopathology? What plays an influence?
Approach to the study of psychopathology which holds that psychological disorders are always
the products of multiple interacting causal factors.
Biological Dimensions: causal factors from the fields of genetics and neuroscience
Psychological dimensions: causal factors from behavioral and cognitive processes
Emotional Influences
Social influences
Interpersonal Influences
Developmental Influences
What are genes?
Long deoxyribonucleic acid (DNA) molecules, the basic physical units of heredity that appear as
locations on chromosomes.
Define polygenic
Influenced by many genes, each contributing a tiny effect.
What is quantitative genetics?
Basically sums up all the tiny effects across many genes, using procedures called quantitative genetics.
What is the diathesis-stress model and how does it work?
INHERITED TENDENCY+STRESS=DISSORDER
Hypothesis that both an inherited tendency (a vulnerability) and specific stressful conditions are
required to produce a disorder.
A model that takes a multidimensional approach
Individuals inherit tendencies to express certain traits or behaviors, which may then be activated
under conditions of stress. Each inherited tendency is a diathesis, which means, literally, a condition that makes one susceptible to developing a disorder.
What is the reciprocal Gene-Environment Model and how does it work?
PREDISPOSITION+TENDANCY TO CREATE RISK FACTORS=DISSORDER
Hypothesis that people with a genetic predisposition for a disorder may also have a genetic tendency to create environmental risk factors that promote the disorder.
Ex: people with a genetic vulnerability to develop a certain disorder, such as blood-injury-injection phobia, may also have a personality traitlets say impulsivenessthat makes them more
likely to be involved in minor accidents that would result in their seeing blood
What makes up the central nervous system?
Brain and Spinal Cord
What is the limbic system? What does it include in the way of control or regulation?
Part of the forebrain
involved in emotion
ability to learn
control impulses
regulation of drives:
sex
hunger
thirst
aggression
What does the peripheral nervous system do? What is it made up of?
Neural networks outside the brain and spinal cord, including the somatic nervous system, which
controls muscle movement, and the autonomic nervous system, which regulates cardiovascular,
endocrine, digestion, and regulation functions.
Autonomic includes sympathetic and parasympathetic
If scared and running away is sympathetic
If you are calming down, parasympathetic
What does the hindbrain do?
Lowest part of the brain stem; regulates many automatic bodily functions such as breathing and
digestion.
Agonists:
Chemical substance that effectively increases the activity of a
neurotransmitter by imitating its effects.
Antagonists:
In neuroscience, a chemical substance that decreases or blocks the effects of a neurotransmitter.
Inverse Agonists:
Chemical substance that produces effects opposite those of a particular neurotransmitter
10 questionsonmatching, will be on neurotransmitters
Know what they do, and what they are associated with
Pg. 47-48
Ex. Saratonin is correlated with depression if dissregulated, then depression occurs
dont forget!
What is serotonin? What does the serotonin system regulate? What happens with extremely low
activity levels of serotonin? Low serotonin activity has been associated with what? What drugs
affect the serotonin system?
Neurotransmitter involved in processing information and coordination of movement as well as
inhibition and restraint; it also assists in the regulation of eating, sexual, and aggressive behaviors, all of which may be involved in different psychological disorders. Its interaction with
dopamine is implicated in schizophrenia and Parkinsons.
What is GABA (you dont need to remember its full name)? What does it do? What does it inhibit primarily? What class of drugs makes it easier for the molecules to attach themselves to the receptors of some neurons? What disorder does GABA play a large effect? Is it specific to that disorder?
Neurotransmitter that reduces activity across the synapse and thus inhibits a range of behaviors
and emotions, especially generalized anxiety.
Dissorders: anxiety
What is norephinephrine? What system is it a part of? What two groups of receptors does it stimulate? How are beta blockers related? Where are the primarily located?
Neurotransmitter that is active in the central and peripheral nervous systems controlling heart
rate, blood pressure, and respiration, among other functions. Because of its role in the body's
alarm reaction, it may also contribute in general and indirectly to panic attacks and other disorders.
What is dopamine? In what disorders has it been implicated? What kinds of behaviors are
dopamine receptors associated with? How does L-Dopa relate?
Neurotransmitter whose generalized function is to activate other neurotransmitters and to aid in
exploratory and pleasure-seeking behaviors (thus balancing serotonin). A relative excess of
dopamine is implicated in schizophrenia (though contradictory evidence suggests the connection
is not simple) and its deficit is involved in Parkinson's disease.
Define learned helplessness
Seligman's theory that people become anxious and depressed when they make an attribution that
they have no control over the stress in their lives (whether in reality they do or not).
Whose name is linked to modeling? And what is modeling or observational learning?
Albert Bandura
Modeling (or observational learning): Learning through observation and imitation of the behavior of other individuals and the consequences of that behavior.
Define prepared learning
Certain associations can be learned more readily than others because this ability has been adaptive for evolution.
Define emotion and its three important and overlapping components
Emotion: an action tendancy
Cognitive:appraisals, attributions, and other ways of processing the world around you
physiology: Brain function involving the more primitive parts of brain
behavior: the basic patterns (freeze, escape, approach, attack) that differ in fundamental ways.
ON TEST
What impact can culture have on psychopathology?
Phobias,women have greater likelyhood
Gender and culture
Bulimia and anorexia are common to woman
In other cultures this isnt an issue
What disorders have shown to have a strong influence of culture and gender? In what disorder is
this most clearly evident?
look up
What does the research on socialization and health say?
look up
Because of psychological stigma, what are people with disorders likely to do?
look up
Define and explain the principle of equifinity
look up
Define clinical assessment
Systematic evaluation measurement of:
psychological
biological
social factors
in a person presenting with a possible psychological disorder.
-Understand
-Predict behavior
-Plan treatment
-Evaluate treatment outcome
What are the three basic concepts on which the value of assessment depends? Define each.
Reliability
Consistency
Validity
Does it do what it is supposed to?
Standardization and Norms
Consistent technical use
Population benchmarks for comparison
Intelligence testing
Made up by educated white males
Designed for white males of similar education
Used on a variety of people
If you use a test make sure it fits the population its being administered to
Pg.71
What is the mental status exam? What 5 components make it up?
Mental Status Exam is a relatively coarse preliminary test of a clients judgment, orientation to
time and place, and emotional and mental state; typically conducted during an initial interview.
Mental Status Exam
1.Appearance & behavior
2.Thought processes
3.Mood and affect
4.Intellectual functioning
5.Sensorium
Mood:
A pervasive and sustained emotion that, in the extreme, markedly colors the persons perception
of the world. Common examples of mood include depression, elation, anger, and anxiety.
Affect
- A pattern of observable behaviors that is the expression of a subjectively experienced feeling
state (emotion). Common examples of affect are euphoria, anger, and sadness.
---- Affect is variable over time, in response to changing emotional states, whereas mood refers
to a pervasive and sustained emotion. Mood is more of a trait, Affect is more of a state.
What does the phrase oriented times three mean?
Patient is aware of, or oriented to, his or her identity, location, and time (person, place, and time)
What is a behavioral assessment?
Behavioral AssessmentMeasuring, observing, and systematically evaluating (rather than inferring) the clients thoughts,
feelings and behavior in the actual problem situation or context.
Focus on here and now
Direct and minimally inferential
Target behaviors are identified and observed
What are the ABCs of Observation?
The ABCs (antecedents, behaviors, and consequences)
What is projective testing? What tests fall under this category?
Project personality aspects onto ambiguous stimuli
Rooted in psychoanalytic tradition
High degree of inference in scoring and interpretation
Two best examples:
Rorschach Inkblot Test
Thematic Apperception Test
Mixed results regarding reliability and validity
What is a personality inventory? What tests fall under this category? What is the MMPI
Self report questionnaires that assess personal traits by asking respondents to identify descriptions that apply to them.
Minnesota Multiphasic Personality Inventory (MMPI, MMPI-2, MMPI-A)
567 true or false items
Extensive reliability, validity, and normative database
MMPI is the empirically derived standardized personality test that provides scales for assessing
such abnormal functioning as depression and paranoia. One of the most widely used and heavily
researched assessment instruments.
What is intelligence testing? What tests fall under this category?
Nature of intellectual functioning and IQ
The deviation IQ
Verbal and performance domains
Developed to predict who would do well in school. IQ test, deviation IQ test, Stanford-binet test,
Wechsler test, WAIS III, WISC III, WPPSI-R.
What is neuropsychological testing? What tests fall under this category?
Assess a broad range of skills and abilities
Goal is to understand brain-behavior relations
Evaluates personal assets and deficits
Overlap with intelligence tests
Measures areas such as receptive and expressive language, attention and concentration,
memory, motor skills, perceptual abilities, and learning and abstraction in such a way that the
clinician can make educated guessed about the persons performance and the possible existence
of brain impairment.
tests, Bender Visual-Motor Gestalt test, Luria-Nebraska Neuropsychological Battery test, and
Halstead-Reitan Neuropsychological Battery
Neuroimaging: Will not be on your exam, but is incorporated in disorders.
Looking inside the brain and take increasingly accurate pictures of its structure and function.
classification
Assignment of objects or people to categories on the basis of shared characteristics
Taxonomy
System of naming and classification in science.
Nosology
classification and naming system for medical and psychological phenomena
What is the classical (pure) categorical approach?
Classical categorical approach Categories
have to have the categories
fits into diagnosis
What is the dimensional approach?
Dimensional approach Classification
along dimensions spectrum
scales, level of functioning
What is the prototypical approach? (this answer might not be sufficient)
Prototypical approach Both classical and dimensional
Define and differentiate reliability and validity
Reliability-degree to which a measurement is consistent, for example, over time or among different raters.
Validity-degree to which a technique actually measures what it purports to measure.
How many Axes are there on the DSM-IV? What is the purpose of each?
5
Axis I
Most major disorders
Axis II
Stable, enduring problems (e.g., Personality Dissorders, Mental Retardation)
Axis III
Medical conditions related to abnormal behavior
Axis IV
Psychosocial problems
Axis V
global clinician rating of adaptive functioning
What are some of the problems with the DSM-IV?What Are the Optimal Thresholds for Diagnosis?
Examples: level or distress, impairment, number of required symptoms
Arbitrary Time Periods in the Definitions of Diagnoses
Should Other Axes Be Included?
Examples: premorbid history, treatment response, family functioning
Is the DSM-IV System Optimal for Treatment or Research?
Problem of Comorbidity
Defined as two or more disorders for the same person
High comorbidity is the rule clinically
Comorbidity threatens the validity of separate diagnoses
Why is it dangerous to label? What are potential dangers of assigning a diagnostic label?
Problem of reification-( Translating a complex set of phenomena into a single entity such as a
number. IQ test scores are an example.)
Problem of stigmatization-( To single a person out as someone to be ashamed of)
By what is the dimensional approach characterized?(double check)
Method of categorizing characteristics on a continuum rather than a binary, either-or, or all-or
none basis.
Glossary of Terms for Mental Disorders
There are 20 questions from the glossary. Know how to differentiate between disorders.
I am not trying to trick you on these questions, just trying to help you differentiate between them.
TEST HELPS
Know id EGO and SUPEREGO
-DIATHESIS STRESS MODEL and RECIPRICOL GENE MODEL
DIFFERENTIATE BETWEEN THE TWO
WHY IS IT DANGEROUS TO LABEL
STIGMAS
KNOW GLOSSARY OF TERMS
GO THROUGH AND FIND ONE PHRASE TO SUMMARIZE EACH
DELLUSION OF GRANDIOSITY IS A DIOGNOSTIC TERM
GRANDIOSITY-NOT AS SEVERE, NOT DIAGNOSED
POVERTY OF SPEECH VS. POVERTY OF SPEECH CONTENT
FLIGHT OF IDEAS VS. PRESSURE OF SPEECH
KNOW DIFFERENCE BETWEEN HALLUCINATION AND DELLUSION
ONE QUESTION ON TESTS
What is Seratonin?
Neurotransmitter involved in processing information and coordination of movement as well as
inhibition and restraint;
What does Serotonin Regulate?
eating
sexual
aggressive behaviors
What happens with low levels of Serotonin?
less inhibition
instability
impulsivity
overreact to situations
Aggression
suicide
impulsive overeating
excessive sex
What drugs effect Serotonin?
SSRIs
Tricyclic antidepressants: imipramine (brand name Tofranil)
Serotonin Specific Reuptake Inhibitors: SSRIs (Prozac)
Used to treat anxiety, mood, eating disorders (fen/phen)
What has serotonin been implicated in?
Interaction with Dopamine is implicated in Schizophrenia and Parkinsons.
What is GABA and what does it do?
Neurotransmitter that Reduces Postsynaptic Activity, or activity across the synapse and thus inhibits a range of behaviors and emotions,
Reduces Anxiety, and tempers emotional responses
What class of drugs makes it easier for the molecules to attach themselves to the receptors of
some neurons?
Benzodizepines (mild tranquilizers) make it easier for GABA molecules to attach themselves to
the receptors of specialized neurons. Higher the level of benzodianzepines, the more GABA that
becomes attached to neurotransmitters and the calmer we become. Relax muscles and reduces
spasams
What disorder does GABA play a large effect?
Anxiety
What is norephinephrine?
Neurotransmitter that is active in the central and peripheral nervous systems controlling heart
rate, blood pressure, and respiration, among other functions.
What system is norepinephrine a part of?
Endocrine System
What two groups of receptors does GABA stimulate?
1.alpha-adrenergic 2.beta-andrenergic receptors
How are beta blockers related to norephinepnrine?
Beta Blockers block the beta-receptors so their response to a surge of norepinephrine is reduced.
Where are norepinephrine receptors the primarily located?
Central Nervous System: one major circuit begins in the hindbrain
What disorders can norepinephrine be implicated in?
Because of its role in the body's alarm reaction, it may also contribute in general and indirectly to
panic attacks and other disorders but not directly involved.
What is dopamine?
Neurotransmitter whose generalized function is to activate other neurotransmitters
What does dopamine balance?
Seratonin
In what disorders has it been implicated?
A relative excess of dopamine is implicated in schizophrenia (though contradictory evidence suggests the connection is not simple) and its deficit is involved in Parkinson's disease.
What kinds of behaviors are dopamine receptors associated with?
Exploratory and Pleasure Seeking
How does L-Dopa relate to dopamine?
L-Dopa is a dopamine agonist, thus increasing levels of dopamine. Since Dopamine switches on
the locomotor system, L-dopa has been successful in reducing some of the effects of Parkinson's
such as tremors, rigidity in muscles, and difficulty with judgment.
Because of psychological stigma, what are people with disorders likely to do?
Not seek health-insurance reimbursement for fear that a coworker might find out.
Define and explain the principle of equifinity
Used in developmental psychopathology to indicate that we must consider a number of paths to a
given outcome.
Ex: a delusional syndrome may be an aspect of shcizophrenia, but it can also arise from amphetamine abuse.